Beyond a doubt, the terrorist attacks of September 11, 2001, caused tremendous stress throughout our nation as we mourned the loss of 2,975 lives in New York, Pennsylvania and the Washington, DC, area. And in the years since, additional victims have fallen—and continue to fall—to cancer and other illnesses caused by hazardous conditions in the disaster areas.

There’s another peril that few people recognize as being attributable to 9/11, though it also continues to cause sickness and death. The people affected by this particular peril—numbering about one million!—are from all over the country. Most of them were nowhere near any of the devastated sites on that dark day 12 years ago, and they didn’t work in the rescue or rebuilding efforts. Yet they are developing and dying from heart disease, cancer and other ailments at a disproportionately high rate.

Why? Because in the aftermath of 9/11, they turned to a very risky behavior to deal with the terrible stress…smoking.


The new study used data collected by the CDC’s Behavioral Risk Factor Surveillance System, a telephone-based survey conducted monthly by each state’s health department. In total, information is gathered from about 400,000 US adults each year, providing a tremendous database of important information.

The questions are designed to assess individuals’ health-related risky behaviors and use of preventive services. For example, questions are posed about alcohol consumption, exercise habits, seat belt use, visits to the doctor and dentist, etc. The survey also asks several questions about smoking, including, “Do you now smoke cigarettes every day, some days or not at all?” And the survey addresses perceived level of stress, asking, “Now thinking about your mental health, which includes stress, depression and problems with emotions, for how many days during the past 30 days was your mental health not good?” The survey questions are the same each year, which makes it easy to draw comparisons.

For this study, Michael Pesko, PhD, assistant professor at Weill Cornell Medical College, looked closely at the data from 1999 through 2003. As expected, there was a huge spike in stress reported in the fourth quarter of 2001 compared with the months prior to 9/11. Additionally between 950,000 and 1.3 million former smokers relapsed right after the terrorist attacks…and started smoking again. Notably, the relapsed smokers lived throughout the US—they were not concentrated only in New York, Washington, DC, and Pennsylvania. It was “extraordinary and surprising to see such a big increase in smoking, seemingly due to one event,” Dr. Pesko said.


Smoking kills more than 440,000 Americans each year. It’s ironic that a habit people turn to when they feel stressed ultimately increases their burden by bringing disease and death.

No one who died on 9/11 or lost a loved one to the terrorist attacks would want to see the tragedy claim another innocent life. If you started smoking again in the aftermath of 9/11 (or if you smoke at all, no matter when you started), why not honor the fallen this year by giving quitting another try? Yes, it is hard to stop smoking, but people can and do succeed and plenty of help is available. So talk to your doctor about proven smoking-cessation and stress-reduction strategies.

For even more information and inspiration on kicking the habit, check out…